ENPC 6th Edition Course Exam
1. A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry
mucous membranes.Vital signs reveal deep respirations at 44breaths per minute, BP of 70/44
mm Hg, and HR of 144 beats per minute. Which of the following laboratory values would be
most expected in this child?
Answer: Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis. Manifestationsinclude
signs of dehydration ( dry mucous membranes, hypotension, tachycardia), incontinence
(polyuria), vomiting, abdominal pain, Kussmaul respirations (to counter the acidosis),
polydipsia, anorexia, and weight loss. Expected laboratory values would reveal an acidotic
state with a pH level below 7.3, an elevated serumbIcarbonate level, and an elevated blood
glucose level > 200 mg.dL.
2. An 18-month-old isseen for fever,slight circumoral cyanosis, and wheezingnoted on
auscultation in the right upper lobe of the lung field after a chokingevent 4 days ago.The white
blood cell count is elevated and the patient notedto be tachypneic, tachycardic, agitated, and
has an increased respiratory effort. At the time of the event, the patient was started on
antibiotics with subsequent increasing manifestations instead of improvement. Which of the
following would be considered to be definitive treatment for the suspected diagnosis?
Answer: Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with subsequent
failure to improve on antibiotics. Wheezing or decreased lung sounds in onearea of the
pulmonary system is a high indicator for a foreign body along with signsof hypoxia such as
cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and
elevated white blood cell counts indicating an infectious process. The definitive treatment
would be a bronchoscopy in order to retrieve the suspected foreign body instead of diagnostic
tests to locate the foreign body itself.
3. A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations
with a bag-mask device. Once return of spontaneous circulation has been confirmed, which of
the following would be the priorityintervention?
Answer: Establishing a secure airway
4. Parents report their 3-year-old child has developed noisy breathing. On assessment,highpitched wheezes are audible and auscultated on inspirationand expiration. What medication
would be appropriate to administer first?
Answer: - Humidified oxygen (wrong)